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饮食中锌摄入量较高会增加自身免疫性甲状腺炎的风险。

Higher dietary zinc intake increases the risk of autoimmune thyroiditis.

作者信息

Chen Lijun, Yan Changjian, Huang Chunling, Jiang Zhengrong, Lin Ruhai, Wu Xiaohong, Huang Huibin

机构信息

Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province 362000, China.

Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province 362000, China.

出版信息

Postgrad Med J. 2025 Jun 22;101(1197):644-652. doi: 10.1093/postmj/qgae202.

Abstract

BACKGROUND

Autoimmune thyroiditis (AIT), encompassing Hashimoto's thyroiditis (HT), is a prevalent chronic autoimmune disorder characterized by lymphocytic infiltration and the presence of anti-thyroid antibodies. It is the primary cause of primary hypothyroidism and affects women more frequently than men. Nearly 95% of individuals with HT exhibit thyroid peroxidase antibodies or thyroglobulin antibodies. Dietary factors, including vitamins and trace elements such as zinc, play a significant role in thyroid health; yet, clinical guidelines lack explicit dietary recommendations for AIT.

METHODS

This study investigates the relationship between dietary zinc intake (Zinc) and AIT using data from the 2007-2008 National Health and Nutrition Examination Survey. A total of 5467 participants were analyzed, including 273 individuals with AIT and 5194 without AIT. Clinical characteristics, dietary Zinc, and other relevant variables were assessed. Multivariate logistic bidirectional stepwise regression analysis was conducted to identify independent risk factors for AIT, and a risk prediction model was developed.

RESULTS

The prevalence of AIT was 5%. Individuals with AIT were older, had a higher proportion of females, and showed elevated levels of various biomarkers, including zinc. Dietary Zinc was significantly higher in the AIT group (22.6 mg vs. 15.3 mg, P < .001). The regression analysis identified dietary Zinc, along with other factors, as an independent risk factor for AIT. The risk prediction model, including zinc, demonstrated a better performance (area under the curve = 0.8) compared to the model without zinc.

CONCLUSION

The findings indicate that higher dietary Zinc is positively correlated with the risk of AIT and serves as an independent risk factor. Excessive Zinc may disrupt immune balance, potentially increasing the risk of autoimmune diseases. These results suggest that dietary Zinc should be carefully considered in the management of AIT, and further research is needed to explore the causal relationship and determine safe zinc consumption levels to avoid increasing the risk of autoimmune diseases.

摘要

背景

自身免疫性甲状腺炎(AIT),包括桥本甲状腺炎(HT),是一种常见的慢性自身免疫性疾病,其特征为淋巴细胞浸润和抗甲状腺抗体的存在。它是原发性甲状腺功能减退的主要原因,女性比男性更易受影响。近95%的HT患者表现出甲状腺过氧化物酶抗体或甲状腺球蛋白抗体。饮食因素,包括维生素和锌等微量元素,在甲状腺健康中起着重要作用;然而,临床指南缺乏针对AIT的明确饮食建议。

方法

本研究利用2007 - 2008年美国国家健康与营养检查调查的数据,调查饮食锌摄入量(锌)与AIT之间的关系。共分析了5467名参与者,其中包括273名AIT患者和5194名非AIT患者。评估了临床特征、饮食锌摄入量及其他相关变量。进行多变量逻辑双向逐步回归分析以确定AIT的独立危险因素,并建立了风险预测模型。

结果

AIT的患病率为5%。AIT患者年龄较大,女性比例较高,且多种生物标志物水平升高,包括锌。AIT组的饮食锌摄入量显著更高(22.6毫克对15.3毫克,P < 0.001)。回归分析确定饮食锌与其他因素一起是AIT的独立危险因素。包含锌的风险预测模型与不包含锌的模型相比,表现更好(曲线下面积 = 0.8)。

结论

研究结果表明,较高饮食锌摄入量与AIT风险呈正相关,且是一个独立危险因素。过量的锌可能会破坏免疫平衡,潜在增加自身免疫性疾病的风险。这些结果表明,在AIT的管理中应谨慎考虑饮食锌摄入量,需要进一步研究以探索因果关系并确定安全的锌消费水平,以避免增加自身免疫性疾病的风险。

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